Problems with Swallowing

Problems with Swallowing

Swallowing issues with solid oral dosage forms affect approximately 20% of older adults and rise to 1/3 in patients in nursing homes. These swallowing issues result in the omission or non-adherence of therapy in about 2/3 of the patients. This leads to a modification of the dosage form (crushing tablets, opening capsules) and mixing in food as a daily practice in nursing homes (see Figure Crushing Tablets). However, the majority of solid dosage forms are neither labeled nor tested for alterations and mixing in food or beverages. Furthermore, crushing and mixing often occur in one vessel for all patients. Control over the dosage form can be lost.

Figure Crushing Tablets: Asking patients to crush a tablet means that these patients per- form a pharmaceutical operation normally performed under Good Manufacturing Practice, supervised by a qualified person and documented.